Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon
Identifieur interne : 001D09 ( Main/Exploration ); précédent : 001D08; suivant : 001D10Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon
Auteurs : Henry D. Meriki [Cameroun] ; Kukwah A. Tufon [Cameroun] ; Mbunkah H. Afegenwi [Cameroun] ; Bernard A. Nyindem [Cameroun] ; Pascal N. Atanga [Cameroun] ; Damian N. Anong [Cameroun] ; Fidelis Cho-Ngwa [Cameroun] ; Theresa Nkuo-Akenji [Cameroun]Source :
- Infectious Diseases of Poverty [ 2049-9957 ] ; 2014.
Abstract
Contemporary data on the immunologic, haematologic and virologic responses and predictors of virologic failure after initiation of free antiretroviral treatment in Cameroon are needed to evaluate the current treatment-monitoring algorithm and to complement efforts to scale-up and improve on the management of HIV infections.
This was a cross-sectional study conducted between October 2010 and June 2012. A total of 951 participants aged 18–74 years were recruited from selected approved HIV treatment centres of the Northwest and Southwest regions. This comprised 247 males and 704 females. Demographic, self-reported risk behaviours and socioeconomic data were obtained using a structured questionnaire. Full blood and CD4 + T-cell counts were done using standard automated techniques. Determination of viral load (VL) was done using Abbott Real
The median duration of antiretroviral therapy (ART) was 24 months. The population mean CD4 + T-cell count was 255.3 cells/μL [95% CI, 236.8 – 273.9]. Overall, 45.9%, 43.8% and 10.2% of the participants had CD4 + T-cell counts of < 200 cells/μL, 200–499 cells/μL and > 500 cells/μL respectively. Anaemia was present in 26.2% of the participants with 62.3%, 25.7% and 12% described as mild, moderate and severe anaemia respectively. Virologic failure occurred in 23.2% of the participants with 12.3% having VL > 10,000 RNA copies/mL. Meanwhile 76.8% of patients attained adequate viral suppression with 40.8% having undetectable viral load. The age group 18–29 years (p = 0.024), co-infection with tuberculosis (p = 0.014), anaemia (p = 0.028) and distance from the treatment centre (p = 0.011) independently predicted virologic failure.
The majority of the participants achieved adequate viral suppression after ≥ 6 months of ART. Despite these favourable immuno-haematologic and virologic outcomes, the National AIDS Control Program should step-up efforts to improve on antiretroviral drug distribution, as well as proper assessment and management of anaemia, foster early diagnosis and treatment of tuberculosis and enhance treatment adherence counselling especially in younger patients.
Url:
DOI: 10.1186/2049-9957-3-5
PubMed: 24479873
PubMed Central: 3922096
Affiliations:
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Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Nyindem, Bernard A" sort="Nyindem, Bernard A" uniqKey="Nyindem B" first="Bernard A" last="Nyindem">Bernard A. Nyindem</name><affiliation wicri:level="1"><nlm:aff id="I2">BioCollections Worldwide Inc. Regional Office, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>BioCollections Worldwide Inc. Regional Office, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Atanga, Pascal N" sort="Atanga, Pascal N" uniqKey="Atanga P" first="Pascal N" last="Atanga">Pascal N. Atanga</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Regional Delegation of Public Health, Southwest Region, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Regional Delegation of Public Health, Southwest Region</wicri:regionArea><wicri:noRegion>Southwest Region</wicri:noRegion></affiliation></author><author><name sortKey="Anong, Damian N" sort="Anong, Damian N" uniqKey="Anong D" first="Damian N" last="Anong">Damian N. Anong</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Cho Ngwa, Fidelis" sort="Cho Ngwa, Fidelis" uniqKey="Cho Ngwa F" first="Fidelis" last="Cho-Ngwa">Fidelis Cho-Ngwa</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Nkuo Akenji, Theresa" sort="Nkuo Akenji, Theresa" uniqKey="Nkuo Akenji T" first="Theresa" last="Nkuo-Akenji">Theresa Nkuo-Akenji</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Faculty of Science Clinical Diagnostic Laboratory, University of Buea, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Faculty of Science Clinical Diagnostic Laboratory, University of Buea, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24479873</idno><idno type="pmc">3922096</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922096</idno><idno type="RBID">PMC:3922096</idno><idno type="doi">10.1186/2049-9957-3-5</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">001410</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001410</idno><idno type="wicri:Area/Pmc/Curation">001409</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001409</idno><idno type="wicri:Area/Pmc/Checkpoint">001298</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001298</idno><idno type="wicri:Area/Ncbi/Merge">002707</idno><idno type="wicri:Area/Ncbi/Curation">002707</idno><idno type="wicri:Area/Ncbi/Checkpoint">002707</idno><idno type="wicri:Area/Main/Merge">001D12</idno><idno type="wicri:Area/Main/Curation">001D09</idno><idno type="wicri:Area/Main/Exploration">001D09</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon</title><author><name sortKey="Meriki, Henry D" sort="Meriki, Henry D" uniqKey="Meriki H" first="Henry D" last="Meriki">Henry D. Meriki</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">BioCollections Worldwide Inc. Regional Office, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>BioCollections Worldwide Inc. Regional Office, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Tufon, Kukwah A" sort="Tufon, Kukwah A" uniqKey="Tufon K" first="Kukwah A" last="Tufon">Kukwah A. Tufon</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Afegenwi, Mbunkah H" sort="Afegenwi, Mbunkah H" uniqKey="Afegenwi M" first="Mbunkah H" last="Afegenwi">Mbunkah H. Afegenwi</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Nyindem, Bernard A" sort="Nyindem, Bernard A" uniqKey="Nyindem B" first="Bernard A" last="Nyindem">Bernard A. Nyindem</name><affiliation wicri:level="1"><nlm:aff id="I2">BioCollections Worldwide Inc. Regional Office, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>BioCollections Worldwide Inc. Regional Office, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Atanga, Pascal N" sort="Atanga, Pascal N" uniqKey="Atanga P" first="Pascal N" last="Atanga">Pascal N. Atanga</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Regional Delegation of Public Health, Southwest Region, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Regional Delegation of Public Health, Southwest Region</wicri:regionArea><wicri:noRegion>Southwest Region</wicri:noRegion></affiliation></author><author><name sortKey="Anong, Damian N" sort="Anong, Damian N" uniqKey="Anong D" first="Damian N" last="Anong">Damian N. Anong</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Cho Ngwa, Fidelis" sort="Cho Ngwa, Fidelis" uniqKey="Cho Ngwa F" first="Fidelis" last="Cho-Ngwa">Fidelis Cho-Ngwa</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Nkuo Akenji, Theresa" sort="Nkuo Akenji, Theresa" uniqKey="Nkuo Akenji T" first="Theresa" last="Nkuo-Akenji">Theresa Nkuo-Akenji</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Faculty of Science Clinical Diagnostic Laboratory, University of Buea, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Faculty of Science Clinical Diagnostic Laboratory, University of Buea, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author></analytic><series><title level="j">Infectious Diseases of Poverty</title><idno type="eISSN">2049-9957</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Contemporary data on the immunologic, haematologic and virologic responses and predictors of virologic failure after initiation of free antiretroviral treatment in Cameroon are needed to evaluate the current treatment-monitoring algorithm and to complement efforts to scale-up and improve on the management of HIV infections.</p></sec><sec><title>Methods</title><p>This was a cross-sectional study conducted between October 2010 and June 2012. A total of 951 participants aged 18–74 years were recruited from selected approved HIV treatment centres of the Northwest and Southwest regions. This comprised 247 males and 704 females. Demographic, self-reported risk behaviours and socioeconomic data were obtained using a structured questionnaire. Full blood and CD4 + T-cell counts were done using standard automated techniques. Determination of viral load (VL) was done using Abbott Real<italic>Time</italic> HIV-1 <italic>m</italic>2000™ system. Data was analysed using SPSS version 17. The statistical significance level was P < 0.05.</p></sec><sec><title>Results</title><p>The median duration of antiretroviral therapy (ART) was 24 months. The population mean CD4 + T-cell count was 255.3 cells/μL [95% CI, 236.8 – 273.9]. Overall, 45.9%, 43.8% and 10.2% of the participants had CD4 + T-cell counts of < 200 cells/μL, 200–499 cells/μL and > 500 cells/μL respectively. Anaemia was present in 26.2% of the participants with 62.3%, 25.7% and 12% described as mild, moderate and severe anaemia respectively. Virologic failure occurred in 23.2% of the participants with 12.3% having VL > 10,000 RNA copies/mL. Meanwhile 76.8% of patients attained adequate viral suppression with 40.8% having undetectable viral load. The age group 18–29 years (p = 0.024), co-infection with tuberculosis (p = 0.014), anaemia (p = 0.028) and distance from the treatment centre (p = 0.011) independently predicted virologic failure.</p></sec><sec><title>Conclusion</title><p>The majority of the participants achieved adequate viral suppression after ≥ 6 months of ART. Despite these favourable immuno-haematologic and virologic outcomes, the National AIDS Control Program should step-up efforts to improve on antiretroviral drug distribution, as well as proper assessment and management of anaemia, foster early diagnosis and treatment of tuberculosis and enhance treatment adherence counselling especially in younger patients.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Mills, E" uniqKey="Mills E">E Mills</name></author><author><name sortKey="Nachega, J" uniqKey="Nachega J">J Nachega</name></author><author><name sortKey="Buchan, I" uniqKey="Buchan I">I Buchan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Crowe, S" uniqKey="Crowe S">S Crowe</name></author><author><name sortKey="Turnbull, S" uniqKey="Turnbull S">S Turnbull</name></author><author><name sortKey="Oelrichs, R" uniqKey="Oelrichs R">R Oelrichs</name></author><author><name sortKey="Dunne, A" 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sortKey="Hirschel, B" uniqKey="Hirschel B">B Hirschel</name></author><author><name sortKey="Battegay, M" uniqKey="Battegay M">M Battegay</name></author><author><name sortKey="Bucher, Hc" uniqKey="Bucher H">HC Bucher</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Skowron, G" uniqKey="Skowron G">G Skowron</name></author><author><name sortKey="Street, J" uniqKey="Street J">J Street</name></author><author><name sortKey="Obee, E" uniqKey="Obee E">E Obee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bello, Ejm" uniqKey="Bello E">EJM Bello</name></author><author><name sortKey="Correia, Af" uniqKey="Correia A">AF Correia</name></author><author><name sortKey="Marins, Jrp" uniqKey="Marins J">JRP Marins</name></author><author><name sortKey="Merchan Hamann, E" uniqKey="Merchan Hamann E">E Merchan-Hamann</name></author><author><name sortKey="Kanzaki, Lib" uniqKey="Kanzaki L">LIB Kanzaki</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Cameroun</li></country></list><tree><country name="Cameroun"><noRegion><name sortKey="Meriki, Henry D" sort="Meriki, Henry D" uniqKey="Meriki H" first="Henry D" last="Meriki">Henry D. Meriki</name></noRegion><name sortKey="Afegenwi, Mbunkah H" sort="Afegenwi, Mbunkah H" uniqKey="Afegenwi M" first="Mbunkah H" last="Afegenwi">Mbunkah H. Afegenwi</name><name sortKey="Anong, Damian N" sort="Anong, Damian N" uniqKey="Anong D" first="Damian N" last="Anong">Damian N. Anong</name><name sortKey="Atanga, Pascal N" sort="Atanga, Pascal N" uniqKey="Atanga P" first="Pascal N" last="Atanga">Pascal N. Atanga</name><name sortKey="Atanga, Pascal N" sort="Atanga, Pascal N" uniqKey="Atanga P" first="Pascal N" last="Atanga">Pascal N. Atanga</name><name sortKey="Cho Ngwa, Fidelis" sort="Cho Ngwa, Fidelis" uniqKey="Cho Ngwa F" first="Fidelis" last="Cho-Ngwa">Fidelis Cho-Ngwa</name><name sortKey="Meriki, Henry D" sort="Meriki, Henry D" uniqKey="Meriki H" first="Henry D" last="Meriki">Henry D. Meriki</name><name sortKey="Nkuo Akenji, Theresa" sort="Nkuo Akenji, Theresa" uniqKey="Nkuo Akenji T" first="Theresa" last="Nkuo-Akenji">Theresa Nkuo-Akenji</name><name sortKey="Nkuo Akenji, Theresa" sort="Nkuo Akenji, Theresa" uniqKey="Nkuo Akenji T" first="Theresa" last="Nkuo-Akenji">Theresa Nkuo-Akenji</name><name sortKey="Nyindem, Bernard A" sort="Nyindem, Bernard A" uniqKey="Nyindem B" first="Bernard A" last="Nyindem">Bernard A. Nyindem</name><name sortKey="Tufon, Kukwah A" sort="Tufon, Kukwah A" uniqKey="Tufon K" first="Kukwah A" last="Tufon">Kukwah A. Tufon</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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